A multi-dimensional assessment of internet gaming disorder in children and adolescents: A case-control study.

BACKGROUND: Internet gaming disorder (IGD) leads to social disturbances and isolation, neglect of daily responsibilities, behavioral disorders, and physical impairments. OBJECTIVE: This study aimed to investigate the effect of IGD on spine biomechanics, range of motion in the neck and low back, and lung functions and respiratory muscle strength in children and adolescents. METHODS: Sixty-four children and adolescents with IGD (Group I) and 41 healthy controls (Group II) were included in the study. The outcomes were assessed with the Visual Analogue Scale (VAS), Internet Addiction Scale, active range of motion (AROM) in the neck and lumbar spine, posture and spinal alignment, lung function tests, and respiratory muscle strength. RESULTS: There is a significant difference in pain intensity at rest, during activity, and daily sitting time between groups (p < 0.05). Craniovertebral angle, shoulder asymmetry, thoracic kyphosis angle, cervical extension and rotation, and right lumbar rotation significantly decreased in Group I than in Group II (p < 0.05). Besides, the PEF, FEF 25-75%, and respiratory muscle strength were lower in Group I than in Group II (p < 0.05). With a multiple linear regression model, MEP, FEV1, and weekly time spent playing online games were significant predictors of internet addiction intensity (R2 = 0.28; p = 0.02, p = 0.01, and p < 0.001, respectively). CONCLUSION: Postural misalignment and increased sedentary time cause physical health deterioration and negatively affect lung functions in children and adolescents with IGD. Consequently, considering both psychological and physical health is necessary to assess the problematic nature of internet gaming. A comprehensive assessment and multidisciplinary team approach is essential to managing the IGD.

INTERNET GAMING DISORDER AND PROBLEMATIC INTERNET USE: THE LINKS BETWEEN CYBERBULLYING, AGGRESSION, LONELINESS AND PSYCHIATRIC COMORBIDITIES.

AIMS: To compare adolescents clinically diagnosed with Internet Gaming Disorder (IGD) and problematic internet use (PIU) in terms of cyberbullying, aggression, and loneliness. METHODS: Male adolescent patients (N=124, 14.3±1.7 years) with Internet Addiction Scale (IAS) scores ≥50 were clinically interviewed for IGD in utilizing DSM-5 criteria. Patients without full IGD criteria were included as PIU comparisons. Clinical variables were assessed using the second version of the Revised Cyber Bullying Inventory, short-form of the UCLA Loneliness Scale, Buss Perry Aggression Questionnaire, Child Depression Inventory, and Screen for Child Anxiety Related Emotional Disorders. RESULTS: Compared to individuals with PIU, those with IGD were significantly more likely to have attention-deficit hyperactivity disorder, higher social phobia scores, higher cyberbullying scores, higher loneliness scores, been a cyberbully, and been a cyberbully victim. CONCLUSION: Male adolescents with IGD have higher rates of psychiatric comorbidity, perceived loneliness, cyberbullying, and being a victim of cyberbullying than those with PIU. Future studies could evaluate these predictors of transition from PIU to IGD in large cohort samples.

Investigating Predictors of Clozapine Response in Adolescents with Schizophrenia and Schizoaffective Disorder.

Objectives: We aimed to determine the clinical predictors of clozapine response in patients with early-onset schizophrenia (EOS)/schizoaffective disorder and the effect of substance use disorder (SUD) on treatment outcomes. Methods: Medical records of patients with treatment-resistant EOS receiving clozapine were identified for data analysis dated between January 2015 and April 2020. Patients on clozapine were followed in an inpatient unit of a tertiary care mental health hospital. Using the Positive and Negative Symptom Scale (PANSS), ≥30% reduction was defined as the response criteria after clozapine treatment. Results: Of 50 subjects (age: 16.3 ± 1.3 years, 36.0% female), 22 subjects (44.0%) met the defined response criteria. Clozapine responder (CLZ-R) and clozapine nonresponder (CLZ-NR) groups were similar regarding age at illness onset, sex, and duration of untreated psychosis. The CLZ-R group had higher baseline positive PANSS scores (24.8 ± 8.1 vs. 17.1 ± 6.6, p = 0.001, d = 1.0) and total PANSS scores (94.8 ± 17.2 vs. 80.1 ± 19.8, p = 0.008, d = 0.8) compared with the CLZ-NR counterparts. The duration of hospital stay was longer in the CLZ-NR group (122.3 ± 48.2 vs. 87.3 ± 36.2 days, p = 0.007). Among 32 male patients, the presence of SUD (n = 9, 28.1%) was associated with a less reduction in total PANSS scores (F = 7.5, p = 0.010) and higher levels of positive symptoms at the end of the treatment (12.8 ± 4.1 vs. 18.8 ± 7.4, p = 0.006, d = 1.0). Synthetic cannabinoids were the most common substance type used among males with treatment-refractory EOS (25.0%). Conclusions: Our results did not support the role of sociodemographic variables in clozapine response. Positive symptoms and SUD yielded a prognostic value in patients receiving clozapine.

Assessment of attitude of parents towards adolescents with Internet gaming disorder.

BACKGROUND: The determination of the protective and risk factors associated with Internet gaming disorder (IGD) is among the most important pathways to the development of prevention strategies for IGD. Previous research has shown that familial factors are associated with IGD. In our study, we aimed to assess the parental attitude of adolescents with IGD and investigate psychiatric comorbidity. METHODS: We assessed family structure, family relationship, parental attitude (in a bi-directional assessment), and psychiatric comorbidity in 50 adolescents aged 12-18 years who meet DSM-5 criteria for IGD in comparison with the control group. Parental attitudes were assessed with the Parental Attitude Research Instrument (filled by the mother) and the Parenting Style Inventory (filled by adolescents). RESULTS: Our findings suggest that according to mothers' opinions there were no significant differences in the subscale scores between the IGD group and the control group. On the other hand, acceptance-involvement and psychological autonomy subscale scores of the PSI filled by adolescents were found to be significantly lower in the IGD group. Limit setting in areas other than the Internet was significantly lower in the IGD group. High rates of psychiatric comorbidity were also found in adolescents with IGD. CONCLUSIONS: Our study identified that adolescents with IGD perceived their parents "cared less about them" and "minded less on their autonomy" compared with the control group. Our survey demonstrated that parental attitudes may be among the risk factors for IGD and the presence of psychiatric comorbidity may affect the management of IGD.